Background
Methods
Study design
Study area and study population
Study participants
Sample size and sampling procedure
Data collection method and procedure
Variables and measurements
Outcome variable
Predictor variables
Factor | Items | Responses | values |
---|---|---|---|
Outcome variables | |||
Latrine ownership | Ownership of latrine | No/Yes for ownership of latrine | 0/1 |
Consistent latrine use | |||
Predictor variables | |||
Risk Perception | |||
Vulnerability | How high or low are the chances that you contract diarrheal disease when defecating in the open field? | Five point scale, that ranges from almost Very low, to Very high | 1 to 5 |
Severity | If you have diarrheal disease because of open defecation, how severely would that impact your life? | Five point scale, that ranges from almost Very low, to Very high | 1 to 5 |
Attitude (affective) | |||
How much beneficial/important it is building Five point scale, that ranges from almost Very low, to Very high your own latrine in the one year | 1 to 5 | ||
How much beneficial/important it is to defecate using latrine regularly | Five point scale, that ranges from almost Very low, to Very high | 1 to 5 | |
How much do you like to use latrine? | Five point scale, that ranges from almost Very low, to Very high | 1 to 5 | |
How much do you do you enjoy defecating in latrine? | Five point scale, that ranges from almost Very low, to Very high | 1 to 5 | |
Self-efficacy (latrine ownership) Injective norm (latrine ownership) | How much ability you think you have building your own latrine in the next one year | Five point scale, that ranges from almost Very low, to Very high | 1 to 5 |
Most of the people in my village think I should have my own latrine | Five point scale, that ranges from completely disagree to completely agree | 1 to 5 | |
People in my village will judge me if I don’t have my own | Five point scale, that ranges from completely disagree to completely agree | 1 to 5 | |
Descriptive norm (latrine use) | Most of the people I know in the community defecate using latrine regularly | Five point scale, that ranges from completely disagree to completely agree | 1 to 5 |
How many of your neighbors use latrine for defecation? | Five point scale, that ranges from almost nobody to almost all | 1 to 5 | |
Using latrine regularly is the right thing to do because everybody does so | Five point scale, that ranges from completely disagree to completely agree | 1 to 5 | |
Injunctive norm (latrine use) | people who are important to me approve /disapprove that you use latrine | Five point scale, that ranges from completely disagree to completely agree | 1 to 5 |
Defecating using latrine is regularly is something that most of the people in my village think | Five point scale, that ranges from completely disagree to completely agree | 1 to 5 | |
People in my village will judge me if I defecate in the open field | Five point scale, that ranges from completely disagree to completely agree | 1 to 5 | |
Cues to action | |||
Exposure to Health education (HEW) | Yes/No | ||
Exposure to CLTSH triggering | Yes/No |
Data management and analysis
Results
Background characteristics of the study participants
Characteristics | Number (%) who didn’t own latrine | Number (%) who own latrine |
---|---|---|
Sex | ||
Male | 166 (58.7) | 484 (63.4) |
Female | 117 (41.3) | 280 (36.6) |
Marital status | ||
Married | 240 (84.8) | 683 (89.4) |
Single/Divorced/widowed/separated | 43 (15.2) | 81(10.6) |
Education Status | ||
No education/informal education | 193 (68.2) | 416 (54.4) |
Primary education | 77 (27.2) | 284 (37.2) |
Secondary education and above | 13(4.6) | 64 (8.4) |
Occupation | ||
Farmer | 276 (97.5) | 733 (95.9) |
Others | 7 (2.5) | 31 (4.1) |
Age | ||
< 31 | 59 (20.8) | 112 (14.7) |
31–50 | 147 (51.9) | 420 (55) |
50+ | 77(27.2) | 232 (30.4) |
Family size | ||
1–6 | 205 (72.4) | 455 (59.6) |
7–10 | 74 (26.1) | 271 (35.5) |
10+ | 4 (1.4) | 38 (5.0) |
Latrine ownership, past experience and future intention
Latrine use
The individual psychological factors
Psychological factors | Range (Min, Max) | Mean | SD | Number of Items |
---|---|---|---|---|
Risk Perception | ||||
Vulnerability | 4 (1, 5) | 4.33 | 0.79 | 1 |
Severity | 4 (1, 5) | 4.48 | 0.75 | 1 |
Attitude | 11 (4, 15) | 13.63 | 1.75 | 4 |
Injunctive norm (latrine ownership) | 8 (2, 10) | .8.0 | 1.79 | 2 |
Self-efficacy (latrine ownership) | 4 (1, 5) | 3.45 | 1.29 | 1 |
Descriptive norm (consistent latrine use) | 11 (4, 15) | 10.37 | 2.32 | 3 |
Injective norm (consistent latrine use) | 11 (3, 15) | 10.37 | 2.31 | 3 |
Exposure to communication about sanitation (cues to action)
Psychological predictors of latrine ownership
Characteristics | Number (%) who didn’t own latrine | Number (%) who own latrine | COR(95%CI) | AOR(95%CI) |
---|---|---|---|---|
1.Psychological factors | ||||
Perceived vulnerability | ||||
Low | 58 (20.5) | 81 (10.6) | 1.00 | 1.00 |
High | 225 (79.5) | 683 (89.4) | 1.15 (0.57–2.32) | 1.15 (0.57–2.32) |
Perceived severity | ||||
Low | 46 (16.3) | 51 (6.7) | 1.00 | 1.00 |
High | 237 (83.7) | 713 (93.3) | 2.71 (1.77–4.15) | 1.15 (0.57–2.32) |
Attitude | ||||
Low | 151 (53.4) | 250 (32.7) | 1.00 | 1.00 |
High | 132 (46.4) | 514 (67.3) | 2.05(1.55–2.71) | 1.70 (1.21–2.37)* |
Injunctive norm (latrine ownership) | ||||
Low | 188 (66.4) | 316 (41.6) | 1.00 | 1.00 |
High | 95 (33.6) | 444 (58.4) | 7.71 (5.70–4.60) | 6.18 (4.46–10.44)* |
2.Cues to action | ||||
Advised by Health extension worker | ||||
No | 17 (6.0) | 67 (8.8) | 1.00 | 1.0 |
Yes | 266 (94.0) | 697 (91.2) | 0.67 (0.38–1.15) | 0.78 (0.41–1.46) |
Family members participated in CLTSH triggering | ||||
No | 256 (90.5) | 569 (74.5) | 1.00 | 1.00 |
Yes | 27 (9.5) | 195 (25.5) | 3.25 (2.12–4.50) | 3.02(1.88–4.84)* |
3.Socio-demographic variables | ||||
Age group | ||||
< 30 | 59 (20.8) | 112 (14.7) | 1.00 | 1.00 |
30–49 | 147 (51.9) | 420 (55.0) | 1.51 (1.04–2.17) | 1.33 (0.87–2.03) |
50+ | 77 (27.2) | 232 (30.3) | 1.58 (1.05–2.38) | 1.66 (0.99–2.80) |
Marital status | ||||
Single/divorced/widowed | ||||
Separated | 43 (15.2) | 81 (10.6) | 1.00 | 1.00 |
Married | 240 (84.8) | 683 (89.4) | 1.51 (1.02–2.24) | 1.43 (0.89–2.28) |
Education Status | ||||
No education/informal Education | 193 (68.2) | 416 (54.4) | 1.00 | 1.00 |
Primary education(grade 1–8) | 77 (27.2) | 284 (37.2) | 1.71 (1.26–2.32) | 1.89 (0.93–3.87) |
High school and college | 13 (4.6) | 64 (8.4) | 2.28 (1.23–4.25) | 1.98 (1.36–2.87)* |
Family size | ||||
< =6 | 205 (72.4) | 455 (59.6) | 1.00 | 1.00 |
> 6 | 78 (27.6) | 309 (40.4) | 1.81 (1.35–2.44) | 1.41 (1.01–1.97)* |
Presence of a school child | ||||
No | 53 (18.7) | 82 (10.7) | 1.00 | 1.00 |
Yes | 230 (81.3) | 682 (89.3) | 1.91 (1.31–2.79) | 1.97 (1.27–3.06)* |
Predictors of consistent latrine use
Characteristics | Number (%) who did not consistently used latrine | Number (%) who consistently used latrine | COR(95%CI) | AOR(95%CI) |
---|---|---|---|---|
Psychological factors | ||||
Perceived vulnerability | ||||
Low | 24 (14.78) | 57 (9.5) | 1.00 | 1.00 |
High | 138 (85.2) | 545 (90.5) | 2.17 (1.50–3.14 | 2.069 (0.97–4.41) |
Perceived severity | ||||
Low | 11 (6.8) | 40 (6.6) | 1.00 | 1.00 |
High | 151 (93.2) | 562 (93.4) | 2.71 (1.77–4.15) | 0.30 (0.11–0.80) |
Attitude | ||||
Low | 108 (66.7) | 142 (23.6) | 1.00 | 1.00 |
High | 54 (33.3) | 460 (76.4) | 6.48 (4.44–9.45) | 7.45 (4.91–11.30) |
Descriptive norm (latrine use) | ||||
High | 71 (43.8) | 257 (42.8) | 1.00 | 1.00 |
Low | 91 (56.2) | 343 (57.2) | 1.04 (0.73–1.48) | 0.95 (0.63–1.44) |
Injunctive norm (latrine use) | ||||
Low | 184 (65.0) | 405 (53.0) | 1.00 | 1.00 |
High | 99 (35) | 359 (47.0) | 1.34(1.00–1.90) | 1.23 (0.80–1.90) |
Demographic variables | ||||
Age group | ||||
< 30 | 22 (13.6) | 90 (15.0) | 1.00 | 1.00 |
30–49 | 92 (58.6) | 328 (54.5) | 0.87 (0.52–1.47) | 0.79 (0.43–1.45) |
50+ | 48 (29.6) | 184 (30.5) | 0.94 (0.53–1.65) | 0.71 (0.35–1.40) |
Education Status | ||||
No/informal education | 84 (52.0) | 332 (55.0) | 1.00 | 1.00 |
Primary Education | 69 (42.6) | 215 (5.7) | 0.79 (0.55–1.13) | 0.66 (0.42–1.05) |
Secondary education | 9 (5.6) | 15 (9.0) | 1.54 (0.74–3.30) | 0.86 (0.36–2.04) |
School child present | ||||
No | 17 (10.5) | 65 (10.8) | 1.00 | 1.00 |
Yes | 145 (89.5) | 537 (89.2) | 0.97 (0.55–1.70) | 0.90 (0.46–1.73) |
Family size | ||||
0–6 | 97 (60.6) | 351 (58.8) | 1.00 | 1.00 |
> 6 | 63 (39.4) | 246 (41.2) | 1.08 (0.76–1.54) | 1.06 (0.71–1.59) |
Gender | ||||
Male | 103 (63.6) | 381 (63.0) | 1.00 | 1.00 |
Female | 59 (36.4) | 221 (37.0) | 1.01 (0.71–1.45) | 1.05 (0.67–1.66) |
Exposure to communication | ||||
Advised by HEW | ||||
No | 20 (12.3) | 47 (7.8) | 1.00 | 1.00 |
Yes | 142 (87.7) | 555 (92.2) | 1.66 (0.95–2.90) | 0.60 (0.35–1.05) |
Participated in CLTSH | ||||
No | 119(73.5) | 450 (74.8) | 1.00 | 1.00 |
Yes | 43 (26.5) | 152 (25.2) | 0.94 (0.63–1.39) | 1.02 (0.64–1.62) |
Latrine quality factors | ||||
Clean latrine | ||||
No | 38 (23.5) | 60 (10.0) | 1.00 | 1.00 |
Yes | 124 (75.5) | 542 (90.0) | 2.77 (1.76–4.35) | 1.69 (1.00–3.00) |
Latrine has protected entry | ||||
No | 144 (89) | 454 (75.4) | 1.00 | 1.00 |
Yes | 18 (11) | 148 (24.6) | 2.61 (1.54–4.40) | 1.94 (1.10–3.48) |
Latrine has superstructure | ||||
No | 96 (59.3) | 222 (37) | 1.00 | 1.00 |
Yes | 66 (40.7) | 380 (63.0) | 2.48 (1.74–3.54) * | 2.26 (1.47–3.48)* |
Discussion
Strength and limitations
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Using a standardized Likert scale adapted from theoretical behavioral models, this study measured the psychological predictors of latrine ownership and consistent latrine use, which was a constraint in previous studies.
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We involved a large sample size and collected preliminary background information using focus group discussion (FGD) as an input for designing the questionnaire, which was the strength of this study.
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We failed to establish causal relationships between potential predictors and the outcome under investigation because our findings were based on a cross-sectional study design.
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We were unable to show the effect of descriptive norm on latrine ownership.